Compassion in urological healthcare

My workplace has four core values that guide our healthcare practices and one of these values is compassion. This overarching philosophy of ‘delivering care with compassion’ drives us to do everything we can to relieve the suffering of those in our care.

I recently watched a short video prepared by our District Health Board as part of a Patient Experience Week. Titled ‘In My Shoes,’ the video invokes the feeling of compassion which comes in the moment we allow ourselves to see the world through another person’s eyes.

The video provides a glimpse into many of the typical experiences individuals have when entering a hospital environment. Interestingly, it captures not only ‘moments’ of patients and families, but also those of healthcare professionals. The video subtitles give perspective to the images shown, but the only voices you hear are at the end of the 2.5-minute video. At that point individual patients ask “if you could sit in this chair,” “if you could lie in this bed,” “if you could stand in my shoes,” “if you could feel what I feel,” would you do anything different? They asked these questions of healthcare professionals from whom they received care. The commentary was a powerful reminder that by putting ourselves in the shoes of others we are best able to treat them with compassion and empathy.

For me this video was a sensitive prompt. As a urology nurse I deliver care to adults suffering from a wide range of urological diagnoses. Some diagnoses result in physical symptoms that significantly impact quality of life, while others may be outwardly invisible with seemingly minimal physical impacts. All of the conditions, however, have the ability to affect an individual’s confidence, well-being and relationships with their friends and families. In a time-pressured workplace environment it is possible to lose sight of this perspective, and the video reminded me that when I allow myself to acknowledge a patient’s ‘lived experience’ of their diagnosis, I deliver the most compassionate and holistic care.

Within days of watching the ‘In My Shoes” I attended a lecture by Prof. Ron Paterson, New Zealand’s Health and Disability Commissioner from 2000 to 2010. He spoke on “Compassion in Healthcare” and addressed the growing concern regarding the ‘absence’ of compassion in modern healthcare. He urged everyone in the healthcare sector to reflect on their practice and made constructive suggestions on how to affect positive change. One of the ideas that resounded most with me was the importance of access to education that focussed on teaching (or reminding) us not only of the ‘nature of suffering’ but of the value that patients place on ‘empathy, kindness and compassion.’ Another was the value of healthcare practitioners modelling the delivery of compassionate care to our colleagues. Essayist Anatole Broyard reminded us of the importance of compassion in his writings. When facing metastatic prostate cancer he wrote:

“Just as he orders blood tests and bone scans of my body I’d like my doctor to scan me, to grope for my spirit as well as my prostate. Without some recognition I am nothing but my illness.”

Centuries earlier Jewish philosopher and physician Maimonides reflected on the need for compassion when he prayed “May I never forget that the patient is a fellow creature in pain. May I never consider him merely a vessel of disease.”

I find both quotes very powerful. As nursing practice advances, we are often giving diagnoses, ordering investigations and educating patients on treatment choices. We may be delivering this care on a daily basis and eventually develop a ‘thick skin’ that enable us to do our routine tasks. We may cultivate a measure of objectivity and distance in our practice to avoid burnout. I believe, however, that the moments we let it show that we care, do not have to be exhausting exchanges filled with strong emotions towards patients or their situations.

Sensitivity to an individual’s or their family’s needs, and a caring manner may be all that is needed to convey compassion. This should be achievable if our healthcare leaders create an ‘environment of caring’ for us to practice in. We need to practice in wellresourced environments where we feel trusted and valued. We also need the support of working within respectful and knowledgeable teams to invigorate us. Such supports will enable us to focus on what matters most to the patients we work with in the outpatient clinics, wards and operating theatres.

I consider access to thought-provoking presentations such as the lecture delivered by Prof. Paterson and the ‘In My Shoes’ video’ as reflective of the goal to support healthcare workers to deliver compassionate care. Each reminds us that it is often the smallest things we do for patients that make the biggest difference. I believe that all nurses have compassion and I hope that as you read this column it will be a gentle prompt for you to also reflect on the question: ‘If you could stand in your patient’s shoes just for a moment, would you do anything any different?’

References
1. Broyard, A. (1992). Intoxicated by my illness and other writings on Life and Death. Clarkson Potters, New York.
2. Paterson, R (2011). Can we mandate Compassion? Hastings Center Report 41(2) p.20-23.
3. Maslen, H. (2013). Is compassion a necessary component of healthcare? Practical Ethics, University of Oxford. http://blog.practicalethics.ox.ac.uk/2013/09/is-compassion-anecessary-component-of-healthcare/ accessed 26/4/2016.
4. Smajdor, A. (2013). Compassion is not the answer to the failings of the NHS. The Guardian. http://www.theguardian.com/healthcare-network/2013/sep/19/compassion-failings-nhs . Accessed 26/4/2016.

Author: Sue Osborne, Urology Nurse, Auckland (NZ), sue.osborne@waitematadhb.govt.nz